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General practice after-hours incentive funding: a rationale for change

Citation

Neil, AL and Nelson, MR and Richardson, T and Mann-Leonard, M and Palmer, AJ, General practice after-hours incentive funding: a rationale for change, Medical Journal of Australia, 203, (2) pp. 82-85. ISSN 0025-729X (2015) [Refereed Article]

Copyright Statement

Copyright 2015 MJA

DOI: doi:10.5694/mja14.01229

Abstract

  • After-hours incentive funding for general practice was introduced in 1998 through the introduction of the Practice Incentives Program (PIP).
  • In 2010, a national audit of the PIP identified after-hours incentive funding as having the greatest levels of non-compliance across 12 PIP components. The audit specified the need for secondary data sources to ensure practice compliance.
  • In this article, we examine the drivers of the 19982013 PIP mechanism to inform development of a fair, transparent and auditable after-hours incentive funding scheme for Tasmania.
  • The PIP after-hours incentive funding mechanism paid, at diminishing levels, for anticipated burden of care (practice size), claimed method of providing care (stream) and remoteness of practice.
  • Increasing remoteness rather than practice size or stream is the primary determinant of urgent after-hours attendances per practice in Tasmania; after-hours attendances to residential aged care facilities are unrelated to individual practice location or stream but concentrated in urban areas.
  • The PIP after-hours incentive funding mechanism does not preferentially support practices that provide after-hours care and arguably led to perverse incentives.
  • A new after-hours incentive funding mechanism embodying pre-specified objectives such as support for (unavoidable) burden and/or provision of care to residential aged care facilities is required. Claimed provision is considered an inappropriate funding determinant.

Item Details

Item Type:Refereed Article
Keywords:medicare locals, general practice, rural, equity
Research Division:Economics
Research Group:Applied Economics
Research Field:Health Economics
Objective Division:Health
Objective Group:Health and Support Services
Objective Field:Health Policy Economic Outcomes
Author:Neil, AL (Dr Amanda Neil)
Author:Nelson, MR (Professor Mark Nelson)
Author:Palmer, AJ (Professor Andrew Palmer)
ID Code:102264
Year Published:2015
Deposited By:Menzies Institute for Medical Research
Deposited On:2015-08-07
Last Modified:2018-03-24
Downloads:0

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